1. Corneal cross linking is generally advised in cases of progressive keratoconus. This can possibly be achieved when you are dealing with a patient who is regularly coming to the clinic for years. In a case where the patient is new and he/she may or may not become a regular one, is cross linking a must whether or not keratoconus is progressing? – Editor, Optometry Today

    1. Thanks for your comments, the corneal cross linking is as you say an indication to halt the progression of keratoconus, if there is no progression it is not necessary, one difficulty nowadays is the lack of one standard criteria for “progression”. We have complementary methods such as the anterior segment UBM that allows us to see early changes at the epithelial layer but not everyone has access to this technology. So in the case of the patient who lives in another city and we are not sure if there is a progression, I recommend taking two things into account, one is undoubtedly the family history, age, the presence of eye rubbing…and on the other hand it is always you can do topographic tracking in the distance with the use of telemedicine.

      CXL is a safe and minimally invasive surgery, but the procedure should be performed only if there is the appropriate indication, not always.

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